Weight loss, medicines may help curb excessive sweating

Thursday

Aug 30, 2007 at 12:01 AM

DEAR DR. DONOHUE: I am a 73-year-old man. Lately I have been sweating profusely on my neck, head and under my arms. I do not sweat on my palms or my soles. Sometimes I take a nap in the afternoon and wake up after a half an hour, soaked. Also, at night when I go to sleep, I literally drip water with no exertion. Do I have hyperhidrosis? I weight 240 pounds and keep my apartment at 70 degrees. Anything you suggest to help me would be appreciated.

Paul G. Donohue, M.D.

DEAR DR. DONOHUE: I am a 73-year-old man. Lately I have been sweating profusely on my neck, head and under my arms. I do not sweat on my palms or my soles. Sometimes I take a nap in the afternoon and wake up after a half an hour, soaked. Also, at night when I go to sleep, I literally drip water with no exertion. Do I have hyperhidrosis? I weight 240 pounds and keep my apartment at 70 degrees. Anything you suggest to help me would be appreciated.

— P.C.

Hyperhidrosis is excessive sweating. I'd say you have it. The sympathetic nervous system controls sweating. It's the part of the nervous system not under our control. It operates on automatic pilot. Sympathetic nerves discharge the chemical acetylcholine, which floats across the gap between nerves and sweat glands. When the chemical lands on a sweat gland, the gland secretes sweat. People with hyperhidrosis are ultra-sensitive to the action of acetylcholine. They sweat buckets. You're one of them. One percent to 3 percent of the population — a large number of people — shares this trait with you.

A few suggestions might help. People who carry too much weight sweat inordinately. Losing a few pounds would serve you in good stead.

A solution of 10 percent to 20 percent aluminum chloride can often end excessive sweating. You need a doctor's prescription for this product. Botox injections work well for underarm sweating. Anticholinergic medicines — drugs that block the action of the acetylcholine chemical — can stanch sweating. Glycopyrrolate, sold under the brand name Robinul, might work for you. It's an anticholinergic. If your pharmacist will do so, he or she can make it into a 0.5 percent lotion or cream to be applied directly to the involved skin. Clonidine is an oral medicine that has had some success in stopping profuse sweating.

Even for localized sweating, your kind of sweating, the possibility of rare causes has to be entertained.

DEAR DR. DONOHUE: I am 75. At my annual physical, my doctor said I have the blood pressure of a teenager but my triglycerides are too high. Will you explain triglycerides and what can be done about them?

— M.R.

Triglycerides are the forgotten characters in the heart disease/stroke/artery-hardening saga. They're fats. The yellowish stuff that encircles a cut of beef is triglycerides. Triglycerides also circulate in the blood and can deposit in arteries to plug them, like cholesterol does.

To lower blood triglycerides, limit the amount of fatty meat you eat and whole-milk dairy products you take in. Losing weight, if need be, lowers triglycerides. Sugar and too much alcohol raise triglycerides. In place of butter and margarine, use olive or canola oil. Regular exercise brings down triglyceride levels.

Omega-3 fatty acids also lower triglycerides. Fish is an excellent source of those fatty acids, and salmon, mackerel and herring are especially rich sources.

If these things don't make a dent in your triglycerides, medicines can. Tricor, Lopid and niacin are three that work well.

DEAR DR. DONOHUE: I have a calcium question. Is calcium citrate more absorbable than calcium carbonate? Is coral calcium better than citrate or carbonate?

— R.P.

Calcium carbonate is the most-often-used calcium supplement. It's also the cheapest. It requires stomach acid for absorption. The best time to take it is at meals, when stomach acid is at its maximum production. Only 500 mg of calcium should be taken at any one time to ensure best absorption.

Calcium citrate is more easily absorbed than calcium carbonate. It's also more expensive. It can be taken at any time of day.

Coral calcium is calcium taken from coral reefs found in the earth's oceans. It is calcium carbonate.

Readers may write to Dr. Donohue or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.